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Monday, December 17, 2012

The body's response to fasting, part 4: in which I actually write about fasting

Well, here it is. To be honest, I'm a little intimidated. I've set this up; now it's time to bring it all together. I guess the best thing to do is take a deep breath and jump in. I should warn you, though, this is going to be a long post.

First, a little disclaimer. I haven't consulted a lawyer, so I don't know if this actually increases my chances of avoiding liability. But even so, it's probably something I should make clear anyway. While I have a fairly strong background in biology, I'm not a health care professional. The purpose of this post is to present certain biological facts and comment on their possible implications for our lifestyle choices, not to give people medical advice.

An important player in the body's response to fasting is a deacetylase called Sirtuin 1 (Sirt1). One of of the functions of Sirt1 is to deacetylate histones, which you'll recall from previous posts changes the cell's pattern of gene expression. But Sirt1 is a busy little deacetylase; it also deacetylates many proteins other than histones, thereby altering their molecular structures and functions. Between the proteins whose gene expression Sirt1 controls via histone deacetylation and the proteins whose function Sirt1 directly affects via deacetylation, Sirt1 has been implicated in functions including metabolism regulation, insulin signaling regulation, cell survival, neuroprotection, cancer prevention, and longevity. And Sirt1 activity is increased by ... fasting! There, as promised I have finally brought this topic around to directly addressing the subject of fasting.

There is one more cellular activity that Sirt1 has been implicated in, and I think it deserves its own paragraph: autophagy. Autophagy is when a cell digests its own molecules or organelles. This may seem like something you wouldn't want your cells doing, but it's necessary for recycling resources that would be better used elsewhere, maintaining a healthy immune system, retiring damaged molecules and organelles, and breaking down proteins that are prone to aggregation (such as the amyloid deposits characteristic of Alzheimer's disease). And this process occurs most efficiently when the body experiences periods of food deprivation. We're just not built to be perfectly well-fed at all times.

So, I've thrown all this information at you about what happens when you fast. Now we all have to decide what to do with that information. At this point I would like to do the responsible thing and tell you that if you want to experiment with fasting in your life, you should consult with your physician. The problem with that is I've talked to many physicians. Most of them don't actually pay that much attention to you when you talk. Most of them have a very limited set of routines they apply to any given problem or question, with very little real problem-solving going on. Very few of them seem to examine the body of information available to them and make well-considered evaluations of the situations presented to them. So I suppose the responsible thing to tell you is first find a physician you trust to use their brain, then consult with them about fasting.

I would also like to point out that while there is a large body of evidence for the benefits of fasting, the same can't be said for how to go about fasting. There are a multitude of fasting regimens out there, and there is little agreement about which one is best. When I wasn't sick, Noel and I enjoyed a routine of fasting on the four quarters of the lunar cycle: full moon, the two half-moons, and the new moon. It let us take something that was good for our bodies and tie it into the larger cycles of the earth. There, after spouting science at you for weeks, I finally said something remotely Pagan-ish. Aren't you happy?

Here's another responsible thing I would like to say, but can't say it without some explanation. I would like to tell you to listen to your body, but that can be tricky when it comes to fasting. Our bodies have adapted to periods of food shortage occurring naturally. All our instincts tell us that if food is available, we should eat it. This would be fine, except that now food is available all the time (I'm making the dubious assumption that if you have access to a computer you have access to food; probably not completely correct, but it probably applies to most of you), but there is significant evidence that it's not healthy to eat all the time. So in order to successfully fast, you have to fight your body to some extent. In fact, all the accounts I have ever read or heard from people who have tried fasting have said that they felt awful until their bodies adjusted to the routine. So listen to your body to some extent, but also keep in mind that fasting is probably not going to feel "good." In fact it could very well feel the opposite of good.

It's also important to remember that water deprivation reaches the deleterious stage much faster than food deprivation, so you absolutely don't want to restrict your water intake. On the other hand, you also have to be careful not to overdo it. Fasting means you're not bringing electrolytes into your body, and an electrolyte imbalance brought on by too much water and not enough calcium, magnesium, potassium, and sodium is nothing to mess around with.

While we're talking about nutrient balance, a lot of the benefits of fasting have been observed regardless of what the quality of the rest of the diet was like. That being said, it's my opinion that fasting shouldn't take the place of making nutritionally balanced food choices. In fact, Sirt1 requires a molecule called nicotinamide adenine dinucleotide (NAD+) to function, and the easiest way for us to synthesize NAD+ is using niacin - an important dietary nutrient found in a wide variety of foods. Also keep in mind that "nutritionally balanced" may not be what our popular culture assumes it is. I would definitely recommend that we all do some research along those lines.

Now, as if things weren't complicated enough, I have one more twist to throw into the mix. Any statements I have made about the effects of fasting apply to healthy animals with a normal genetic makeup. In fact, there is some evidence that certain genetic variations can cause effects oppositeto the ones I've described. So if you have any infection, disease, or genetic abnormality, do not mess around with your health. Find a physician you trust to use their brain (see above), and let them help you figure out if fasting is something you should try before proceeding. You'll notice I mentioned that I fasted when I wasn't sick. Now that I'm wrestling with the aftermath of a nasty virus, I've been avoiding fasting because I don't know how it could affect my recovery. Fasting puts the body into breaking-down-molecules/releasing-energy mode, and to heal from an illness you need your body to be in building-up-molecules/storing-energy mode.

The same thing applies to children. Children need to do a lot of molecule-building, and fasting (beyond missing a meal because they turned up their noses at your dinner) could be disruptive to those processes. So I would be very leery of anyone fasting who has not reached full physical maturity. And by extension, I would also avoid it if I were pregnant.

Whew! I finally got it all out. Now I have to figure out what I'm going to write about for next time. If anyone has any suggestions, feel free to share them. Also, happy holidays!